The state Assembly passed a single-payer health care bill Tuesday that would provide universal coverage statewide. However, the bill faces a difficult path through the Republican-controlled state Senate, and economists have conflicting views on how it would affect spending and taxation.

The bill's sponsor, Manhattan Democrat Richard Gottfried, said House Republicans' passage of the American Health Care Act makes it more important that the state Legislature act to preserve affordable health care.

"As bad as things are today … what Washington is looking at doing to Medicaid and Medicare and private insurance is going to make it a lot worse," he said.

The New York Health Act, which previously passed the Assembly three times but stalled in the Senate, would provide no-cost coverage to every New Yorker with no out-of-pocket costs and no network restrictions. It would be paid for through a progressive payroll tax and levies on non-earned income, such as capital gains. A 2015 analysis from Gerald Friedman, professor of economics at the University of Massachusetts at Amherst, showed a potential savings of $45 billion in the first year of implementation

Avik Roy, president of the Foundation for Research on Equal Opportunity, a Texas think tank, did his own analysis in March and concluded that Friedman's assumed savings from lower administrative and drug costs and reduced fraud wouldn't materialize. He said the bill would require $226 billion in tax increases, quadrupling the state tax burden.

Bill Hammond, director of health policy at the Empire Center for Public Policy, said he also found flaws in Friedman's analysis. "I'm concerned the Legislature is rushing into this based on ideological beliefs rather than a hard-nosed look at how this would or would not work in New York state," Hammond said.

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